Becoming OUT Spoken: The development of a trauma-informed therapy service for male prisoner-survivors of sexual assault

Delivering trauma informed therapy to male survivors of sexual assault in prison involves distinctive ethical, institutional, and clinical challenges. Men in custody disproportionately report extensive childhood adversity and prior victimization, including high levels of sexual abuse, which are often intensified by the traumatizing conditions of imprisonment. This chapter examines how OUT Spoken—a trauma informed talking therapy service operating across fifteen prisons in the Northwest of England—has attempted to meet these challenges. Drawing on interviews with professionals involved in commissioning, delivering, and supporting the service, we analyze the organizational and environmental barriers to therapeutic work and highlight the strategies practitioners use to establish safety, promote stabilization, and support engagement among a client group with complex service needs. The findings provide critical insights for commissioners, service providers, and practitioners seeking to develop ethical and effective therapeutic responses for male survivors of sexual abuse with histories of criminal justice involvement, illuminating both the potential and limitations of trauma informed practice within inherently trauma inducing institutions, such as prisons.